Notably, our commercial flywheel has achieved a new level of velocity, delivering our fastest year-over-year percentage revenue growth in the last five years and surpassing the $1 billion trailing 12-month revenue milestone. Patient outcomes like this are one of the many reasons we have benefited from accelerating adoption and growth. Turning to our revenue performance in slide four, we had a phenomenal start to 2026, delivering $302 million of revenue in Q1, representing 48% year-over-year growth. The growth was strong and broad-based across our oncology, biopharma and data, and screening business lines.
Taking a closer look at our oncology business in slide five, oncology revenue growth accelerated to 36% year-over-year, driving Q1 revenue of $205 million. This was the highest year-over-year percentage growth in oncology volume we've seen in nearly three years, with strength across all products. Turning to slide six, our 47% year-over-year volume growth reflects the increasing breadth of our portfolio across both therapy selection and MRD. Guardant360 Liquid delivered 30% volume growth year-over-year, while Guardant360 Tissue was our second fastest-growing product.
Smart Platform innovation continues to translate directly into volume growth for both products, with InfinityAI powering a steady cadence of new clinical applications that are driving deeper adoption among oncologists. We have a strong pipeline of additional Smart Apps in development, and we look forward to continuing that cadence. The result is a compounding flywheel wherein data drives better insights, which in turn fuels volume growth and strengthens our data advantage. Turning to slide eight to take a closer look at our Reveal data pipeline.
| Metric | Period | Current guidance |
|---|---|---|
| Total revenue | Full year 2026 | $1.30B-$1.32B (32%-34% growth) (raised) |
| Oncology revenue growth | Full year 2026 | 28%-29% (volume growth greater than 35%) (raised) |
| Screening revenue | Full year 2026 | $186M-$198M (Shield volume ~230,000-245,000 tests) (raised) |
| Biopharma and data revenue growth | Full year 2026 | low double-digit range (reaffirmed) |
| Non-GAAP gross margin | Full year 2026 | 64%-65% (reaffirmed) |
| Non-GAAP operating expenses | Full year 2026 | $1.05B-$1.07B (16%-18% growth) (new) |
| Free cash flow burn | Full year 2026 | $185M-$195M (improvement YoY) (reaffirmed) |
| Metric | YoY | Note |
|---|---|---|
| Total revenue | +48% | Broad-based momentum across oncology, biopharma and data, and screening, with the commercial flywheel reaching new velocity. |
| Oncology revenue | +36% | 47% test volume growth across the portfolio driven by Smart Platform and InfinityAI clinical applications. |
| Guardant360 Liquid volume | +30% | Expanding clinical utility and continued Smart Apps traction, plus share gains and broader physician adoption. |
| Reveal volume | exceeding 100% | Strong MRD adoption across indications and enthusiasm for the new therapy response monitoring use case in its first full quarter post-launch. |
| Screening revenue | from $6M to $42M | Roughly 44,000 Shield tests versus 9,000 a year earlier, plus the Medicare rate step-up from $920 to $1,495 effective April 1, 2025. |
| Biopharma and data revenue | +17% | Sustained demand across sample testing, companion diagnostic projects, and data products. |
| Shield non-GAAP cost per test | from $520 to $420 | Higher volumes, disciplined cost management, and efficient lab operations. |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Shield commercial momentum | Volume tracked as expected through January and February | Accelerated sharply in March from DTC/influencer campaigns and the Quest partnership launch, prompting a raised full-year guide | Accelerating |
| Reveal MRD and reimbursement | Therapy response monitoring launched in Q4 2025 | Fastest-growing product with data packages submitted to MolDX for breast surveillance and IO/chemo monitoring, representing ASP upside catalysts | Expanding |
| InfinityAI / Smart Platform data moat | — | Data repository spans over 1 million patient samples and 500,000 epigenetic profiles, powering 25 of 38 AACR abstracts and new Smart Apps | Deepening |
| Quest Diagnostics collaboration | Prior outlook excluded Quest benefit | Launched nationwide in late Q1, fast-tracking EMR connectivity to more than 650,000 HCPs with positive early contributions now factored into guidance | Ramping |
| Camizestrant / SERENA-6 monitoring | — | AdCom voted six to three against clinically meaningful benefit; management views Reveal therapy monitoring and MolDX submissions as the primary path, with any approval as upside | Uncertain |